Healthcare Provider Details

I. General information

NPI: 1770409880
Provider Name (Legal Business Name): NIA IMANI DARBEAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 W LANCASTER BLVD
LANCASTER CA
93534-2303
US

IV. Provider business mailing address

815 W LANCASTER BLVD
LANCASTER CA
93534-2303
US

V. Phone/Fax

Practice location:
  • Phone: 661-903-8822
  • Fax: 661-231-3143
Mailing address:
  • Phone: 661-903-8822
  • Fax: 661-231-3143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC22998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: